MEDICARE: JULIET DM CHRISTIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1952055170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIET DM CHRISTIE

Provider Business Mailing Address
First Line	:	6086 BLUE GRASS CIR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6645
Country	:	US
Telephone Number	:	561-412-7621
Fax Number	:

Provider Business Practice Location Address
First Line	:	6086 BLUE GRASS CIR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6645
Country	:	US
Telephone Number	:	561-412-7621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2022
Last Update Date	:	02/07/2022

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Directions to “ JULIET DM CHRISTIE ” Practice Location

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